Hypertension Management Flashcards
What is stage 1 hypertension?
135/85-149/94
What is stage 2 hypertension?
150/95 or more
Is clinic blood pressure testing enough to diagnose hypertension?
No need ambulatory (preferably) or home BP monitoring
When would you consider drug treatment in someone with stage 1 hypertension?
> 80 with clinic BP >150/90 (as this is treatment target in >80)
Age <80 with target organ damage, CVD,
renal disease, diabetes or 10-year CVD
risk ≥10%
Age <60 with 10-year CVD risk <10%w
When would you consider drug treatment in someone with stage 2 hypertension?
Consider in everyone?
When would you consider drug treatment in someone with stage 2 hypertension?
Consider in everyone
What should you do if someone has hypertension and is <40
Consider specialist evaluation of secondary causes
How often should people with hypertension be reviewed?
Annually
Who would you treat first line with an ACEI or ARB?
Anyone with diabetes of any age (type 1 and 2)
People under 55
Who would you treat first line with a CCB?
People over 55
People of Black African or African-Carribean family origin of any age
Second line hypertension treatment
Adding in either ACEI/ARB or CCB (depending on what was used first line)
OR
Thiazide-like diuretic
Third line hypertension treatment
ACEI/ARB
And
CCB
And
Thiazide-like diuretic
What to do if third line drug treatment for hypertension fails
Confirm ABPM
Discuss adherence
Consider speaking to specialist
OR
Add spironolactone if potassium <4.5
OR
Alpha or beta blocker if potassium >4.5
What to do if spironolactone or alpha or beta blocker fails?
Seek expert advice
What are the BP treatment targets for <80 years?
Clinic BP <140/90 mmHg
ABPM/HBPM <135/85 mmHg
